Supervisor – Care Management, Non-clinical

This is a fully remote position, open to applicants in California.

📋 Description

• Oversee the daily operations of care management teams

• Manage the provision of clinical care management services across all stages

• Ensure compliance with policies, procedures, regulatory standards, and quality benchmarks

• Track the implementation of care management processes, training, and documentation needs

• Analyze health plan reports to identify members who need care coordination or interventions

• Guarantee adherence to NCQA, CMS, health plan, state, and internal standards

• Assist in the creation and evaluation of personalized care plans

• Collaborate with PCPs, specialists, vendors, Utilization Management, Inpatient Case Management, and Ambulatory Care

• Perform internal case audits and provide constructive feedback, coaching, education, and support to staff

• Aid in fulfilling health plan audit requirements

• Conduct performance assessments and keep track of staff attendance

• Mentor, recruit, onboard, and train new staff members

• Maintain employee timekeeping and personnel documentation

⛳️ Requirements

• A high school diploma is a must

• Management diploma or certificate is preferred

• A minimum of 2 years of experience in case/care management within a medical group, IPA, and/or HMO environment is preferred

• Familiarity with NCQA standards, Model of Care and Case Management requirements, CMS and state regulations, along with HMO/ACO structural models

• Excellent communication, leadership, and critical thinking abilities

• Demonstrated capability to collaborate across various functions with clinicians, leadership, and administrative personnel to achieve results

• Experience in managing diverse teams and spearheading quality-focused initiatives

• Proficient in the Microsoft Office suite and capable of learning and navigating other software systems

🏝️ Benefits

• This position is remote.

• Travel may be necessary based on business requirements.

• We are an Equal Employment Opportunity and Affirmative Action employer.

• Reasonable accommodations are available for applicants with disabilities.